Social Work with Difficult Cases and Vulnerable Populations.

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Presentation on theme: "Social Work with Difficult Cases and Vulnerable Populations."— Presentation transcript:

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Social Work with Difficult Cases and Vulnerable Populations

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What is a difficult case? “When we call a client difficult, what we really mean is that we, the therapists, are having difficulty working with him/her.” (Wessler)

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What is a difficult case? “Difficult patients are those who make us feel frustrated, uncomfortable, or ineffective....” (Duxbury) Difficult patients present some type of threat: They can reject us or harm us. (Duxbury) Difficult patients are those whose disorders don’t respond to treatment. (Pollack) Difficult families are those that don’t allow separation and differentiation. (Bergman)

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We may define difficult people as those who lead us to do things we don’t want to do: 1. react in ways we are not happy with 2. do our jobs ineffectively 3. feel guilty, anxious, upset, frustrated, inferior, defeated, etc. 4. do their share of the work

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Difficulty is about unmet needs. The behaviors that make it difficult for us to work with clients result from our failure to meet their needs. When needs are not met, patients react by demonstrating:

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Indicators of Axis II features. 1. Life-long nature of a problem. 2. Persistent non-compliance with treatment. 3. Initial improvement comes to a plateau. 4. Patient seems unaware of the effect their behavior has upon others. 5. Therapist suspects the patient of lacking motivation to change. 6. Problems are reported as seeming natural to the patient—”That's the way I am”.